by Maryla Król
“Importing drugs from Canada puts every US patient at risk” – so says an advertisement recently uploaded to YouTube by the industry-funded Partnership for Safe Medicines.
The film broadcasts a stark warning, supported by images juxtaposing a pristine US drugstore with a gloomy Chinese laboratory, manufacturing medicine in what appear to be decidedly unsanitary conditions.
So, are we to believe that Canadian drugs actually contain a potentially lethal cocktail of ‘antifreeze, drywall and road paint’ or does the film promote a more cynical underlying message?
Putting the brakes on Canadian import plans
Although purporting to present facts about counterfeit medicines, the ad is in many ways deceptive. The fact is that no country manufactures all its meds – 80 percent of the active ingredients used in domestically produced American drugs are imported, for example, making the US the largest importer of drugs from abroad with an annual spend of more than $85 billion.
Like America, Canada is extremely vigilant about the safety of the drugs that are imported and sold in that country and regularly advises citizens of the dangers of buying drugs online. In common with the US, Canada also carefully monitors all drugs imported from elsewhere. The World Health Organization (WHO) concurs that the percentage of counterfeit drugs sold in countries like the US and Canada may be as low as just 1%. In which case, what’s the story?
The advert is a response to plans by some US lawmakers to recommend the importation of (cheaper) Canadian drugs as a way of addressing the sky-high cost of home-grown pharma. It may not surprise viewers to learn that membership of the PSM comprises largely of US drug companies and pharmacies that are campaigning aggressively to prevent Americans from obtaining their meds from over the border.
High prices stimulating the demand for imports
The campaign is set against a backdrop of public dissatisfaction with the mounting costs of drugs. America boasts the highest drug prices in the world: the US spent $1,162 per person on drugs in 2015, according to the Organization for Economic Cooperation and Development (OECD). Not only is the price of new drugs lofty – often more than $100,000 per year for life-threatening conditions – but even established treatments outstrip inflation with routine annual hikes in the region of 10 percent. The story is the same at the pharmacy counter where Americans are being required to pay a higher proportion of prescription costs under their health insurance plans.
President Trump has promised to lower drug prices, but his latest strategy seems to fall short, instead focusing on increasing competition and encouraging greater transparency over costs. There’s no sign, either, of a former campaign pledge to leverage Medicare’s buying power to negotiate price discounts for seniors.
In November 2017, the World Health Organization (WHO) warned that counterfeit drugs were becoming increasingly common, as patients were motivated to source lower-cost alternatives to branded meds. The report recorded examples of US doctors obtaining cancer medicines over the Internet in order to save money, in some instances exposing patients to fake medicines with no active ingredients. In this context, Canada provides the best alternative for many, as licensed Canadian online pharmacists have to be approved by the government.
Canada still has progress to make in healthcare reform
Which is not to say that the Canadian healthcare system is perfect. The government is currently looking into the creation of a universal, national pharma program that would extend public health insurance to include prescription drugs outside of the hospital. At the moment, the rising cost of health plans benefits pharma and insurance companies, to the detriment of ordinary citizens, some of whom struggle to meet the cost of their prescriptions.
Patients suffering from rare diseases are also often required to wait longer than those in other countries before they can access effective drug regimens. Last year, for instance, the breakthrough drug Spinraza was approved by Health Canada to treat spinal muscular atrophy, a rare, debilitating and frequently fatal disease.
Currently, the cost of the treatment has to be signed off by the Canadian Agency for Drugs and Technologies in Health, which recommended in December 2017 that only a small group of patients with the most severe form of the disease should be covered. In the meantime, the provincial governments have yet to finish their negotiations for a reimbursement agreement for the drug.
Given the fact that the drug is the only treatment for the disease, however, patients’ groups and families of sufferers have been calling on their government to take more concerted action in a process that could take years. This, in stark contrast with the fact that Spinraza has already been approved in numerous developed nations, including the US and France.
In addition to its faulty record on these kinds of rare diseases, Canada also lags behind in R&D, according to the OECD figures for 2015. Not only has the country ceded its top ten place in the overall spending rankings, dropping way behind nations such as the US and China, but is also being outspent by countries such as Russia, India and Brazil. Canada’s investment as a percentage of GDP has also fallen below the OECD average of 2.4 percent.
Canada has a clean bill of health for pharma safety
There can be no doubt that Canada’s highly regulated pharma industry supplies safe medicines to its citizens, though – as well as to Americans who may acquire them.
The PSM ad may try to push the notion of Canada as a prime conduit for Chinese counterfeiters but it’s an argument that doesn’t bear close scrutiny. Most importantly, it certainly won’t make the reality of inflated US drug prices a less bitter pill to swallow.
Maryla Król is a Polish-American research assistant working for an economic think tank in Geneva and specializing in EU affairs. Her main research areas include European energy policy and relations with Eastern and Southern Europe. She is a regular contributor to European media sites including EU Observer and maintains an active blog on CommDigiNews.